Sleep Study Billing
The field of sleep medicine is growing fast in recent years due to the rising prevalence of sleep disorders. Obstructive sleep apnea is increasingly recognized as a comorbidity in many medical illnesses. This has resulted in an increasing need for sleep testing, which is not entirely met by the currently available sleep laboratory facilities. Home, or out-of-center, sleep testing is an alternative to in-laboratory studies. However, many sleep medicine practices struggle with revenue leakage, under payment or denials.
Steps in the billing process for sleep studies can vary depending on a range of factors like monitoring devices used, location of the test etc. At RCM Workshop, our deep expertise in sleep study billing guidelines and extensive experience in revenue cycle management ensure the precision and proficiency of your sleep study billing processes. As a sleep medicine doctor, you take care of your patients and partner with us to take care of your billing.
Unbeatable Service, Quality & Price
ACCURACY
0
%
TURNAROUND TIME
<
0
Hours
COLLECTION
0
%
PRICE
Starting from $
1100
/Month
Challenges
Challenges in Sleep Study Billing
An efficient billing system for sleep study must have adequate knowledge and understanding of the billing process, knowledge of sleep study coding and documentation requirements.
The major challenge in sleep study reimbursement is incorrect coding and/or absence of required documentation as medical necessity. An efficient coding & billing process must ensure accurate coding – diagnosis codes (ICD-10) for sleep disorders and procedure codes (CPT) for sleep study service or medicine. It is also important to give due consideration for type of machine used for sleep study and location of test etc. to get correct reimbursement. Appropriate use of modifiers for specific duration of sleep test is also important to get correct reimbursement.
In addition to correct coding, all relevant information should be documented in the patient’s medical record. This includes the indications for the study, the type of study performed, and any associated comorbidities. Our pain management billing emphasizes on accurate coding and documentation and that helps sleep study practices overcome complex reimbursement procedures.
OUR PROCESS
Our Sleep Study Billing Process Workflow
Our dedicated team of talented and skilled coders and billers, comprehensively addresses all your billing needs, ensuring swift and accurate payments. Our expert billers and coders have extensive knowledge of sleep study billing intricacies to support your entire revenue cycle starting from identifying patient eligibility, obtaining prior authorization approval to denial management and AR follow-up. Our prior authorization service offers exceptional benefits to your business through a structured and methodical approach to obtain PA approval and eliminate the risk of denials.
Our analytics driven approach helps us monitor, measure and manage every billing process based on key performance indicators (KPI). Our metrics driven reporting tool captures and reports every aspect of process performance – productivity, quality and $ collections in a transparent way and gives you full control over your billing process.
Scheduling & Registration
Well coordinated appointment Scheduling, update insurance details and handle inbound outbound calls from/to patients.
Eligibility & Benefits Verification
Confirm patient primary and secondary insurance and benefits coverage and verify the patients’ coverage, co-pays, co-insurance and deductibles
Prior Authorization
Initiate request for prior authorization with the payer, follow-up to check Auth status till closure and finally update the system with Auth approval reference number.
Medical Coding
Check accuracy of codes and modifier according to specialty and assign corresponding and appropriate charges to the codes.
Charge Posting
Audit the claims thoroughly to check for accuracy and edit if necessary and submit claims – both EDI and paper format.
Claims Edit & Submission
Audit the claims thoroughly to check for accuracy and edit if necessary and submit claims – both EDI and paper format.
Payment Posting
Carry out both auto as well as manual posting for payments received and conduct reconciliation against claims.
Denial Management
Analyse and categorize denial claims according to denial codes, $ amount and payers, and resubmit claims after correction.
AR Management
Follow-up with payers to gather status for unpaid claims, and their resolution.
Patient Collection
Sending patient statements and follow-up with patients for final and outstanding payment.
You have the flexibility to assign us either your complete billing process or choose a combination of our specialized physician billing services. Our effortless integration guarantees improved revenue and steady cash flow, seamlessly aligning with your facilities operations.
BENEFITS
Outcomes Guaranteed
Outsourcing your billing requirement, you not only improve your revenue but gain patient trust and boost efficiency in your practice. By streamlining this process, we assure you a much-improved financial outcome – maximized revenue, steady cash flow and reduced operational cost. Above all we are fully compliant with HIPAA and comply with all regulations.
Efficient benefits verification
>99% clean claim submission
Efficient authorization management
<24 hours turn-around time
Efficient coding & code review
>25% increased reimbursement
Efficient denial management
<5% claims denials
Proactive accounts receivable follow-up
<40 days AR & reduced aging
Better coordination & process optimization
improved patient satisfaction
WHY US?
Why partner with us
Our sleep study billing services seamlessly encompasses all facets of your billing needs, harmoniously integrating into your existing billing infrastructure to maximizing your practice’s revenue. By following best practices for quality assurance and compliance and update on regulatory guidelines, we continuously strive for process improvement. We are committed to delivering unparalleled support and productivity, while helping you optimize your revenue cycle. Partnering with us for your billing needs offers a host of benefits – experience how our services transform your billing process.